<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('User_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-user_id" data-rule="required" data-source="user/index" data-field="nickname" class="form-control selectpage" name="row[user_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Real_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-real_name" data-rule="required" class="form-control" name="row[real_name]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Id_card')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-id_card" data-rule="required" class="form-control" name="row[id_card]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bank_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bank_name" data-rule="required" class="form-control" name="row[bank_name]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Branch_bank_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-branch_bank_name" data-rule="required" class="form-control" name="row[branch_bank_name]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bank_card')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bank_card" data-rule="required" class="form-control" name="row[bank_card]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Id_image1_pic')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-id_image1_pic" data-rule="required" class="form-control" size="50" name="row[id_image1_pic]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="plupload-id_image1_pic" class="btn btn-danger plupload" data-input-id="c-id_image1_pic" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp" data-multiple="false" data-preview-id="p-id_image1_pic"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-id_image1_pic" class="btn btn-primary fachoose" data-input-id="c-id_image1_pic" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-id_image1_pic"></span>
            </div>
            <ul class="row list-inline plupload-preview" id="p-id_image1_pic"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Id_image2_pic')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-id_image2_pic" data-rule="required" class="form-control" size="50" name="row[id_image2_pic]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="plupload-id_image2_pic" class="btn btn-danger plupload" data-input-id="c-id_image2_pic" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp" data-multiple="false" data-preview-id="p-id_image2_pic"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-id_image2_pic" class="btn btn-primary fachoose" data-input-id="c-id_image2_pic" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-id_image2_pic"></span>
            </div>
            <ul class="row list-inline plupload-preview" id="p-id_image2_pic"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Id_image3_pic')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-id_image3_pic" data-rule="required" class="form-control" size="50" name="row[id_image3_pic]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="plupload-id_image3_pic" class="btn btn-danger plupload" data-input-id="c-id_image3_pic" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp" data-multiple="false" data-preview-id="p-id_image3_pic"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-id_image3_pic" class="btn btn-primary fachoose" data-input-id="c-id_image3_pic" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-id_image3_pic"></span>
            </div>
            <ul class="row list-inline plupload-preview" id="p-id_image3_pic"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status_data')}:</label>
        <div class="col-xs-12 col-sm-8">
            
            <div class="radio">
            {foreach name="statusDataList" item="vo"}
            <label for="row[status_data]-{$key}"><input id="row[status_data]-{$key}" name="row[status_data]" type="radio" value="{$key}" {in name="key" value="0"}checked{/in} /> {$vo}</label> 
            {/foreach}
            </div>

        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
